Cardiovascular manifestations in patients treated with periodic hemodialysis through functional arteriovenous fistula

Abstract

Introduction: Cardiovascular manifestations produced by the arteriovenous fistula in patients treated with hemodialysis are an important aspect, as cardiovascular disease is the leading cause of morbidity and mortality. Objective: To determine the cardiovascular manifestations in patients with a functional arteriovenous fistula treated with regular hemodialysis. Method: Descriptive, transversal study, with 81 patients in dialysis treatment who had a functional arteriovenous fistula. Clinical records were reviewed, and a transthoracic echocardiogram was carried out. Association between variables was determined by statistical tests. Results: There was a significant difference in the hemodialysis treatment time in patients with hypertrophic cardiomyopathy, 70% in less than 4 years against 100% in more than 4 years (p=0.03), valve diseases 67.4 vs. 94.3% (p=0.03), and pulmonary hypertension 26.1 vs. 57.1% (p=0.05); and also regarding the diameter of the left atrium 45.1±4.7 mm, less than 4 years, against 50.9±7.6 mm, more than 4 years (p=0.00). E' wave velocity 7.9±1.4 cm/s vs. 7.2±1.7 cm/s (p=0.045). Interventricular septum 16.4±3.1 mm vs. 18.5±4.9 mm (p=0.021), and posterior wall 14.6±2.5 vs. 16.5±3.1 mm (p=0.003); as well as mean pulmonary artery pressure 25.6±7.5 mmHg vs. 29.3±8.4 mmHg (p=0.042). Conclusions: No relationship was found between the fistula location and changes in the cardiovascular system. The group of patients with more than four years-fistula presented major cardiovascular events and significant changes in the echocardiogram.